999 Functional acknowledgement

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This section applies to the 997, 999 and possibly other types of feedback that you might receive from a payer.

 

After you send your EDI insurance claims, the payer may provide an acknowledgement immediately or within 24 hours. Typically this acknowledgement will give you the results of a 'pre-pass' edit. This is a list of errors (if any) in your transmitted file that relate to structure or some basic problem with the file. Typically it will not tell you that the claim will be paid. You should consider this to be a way for the payer to tell you that your transmission was received. From the main directory you will notice that one of the lower menu selections will change to notify you that a file has been received:

 

 

11_edi_08_01_mainmenu

 

After you select the newly received mail file, you will see the screen below. Select 'View'

 

 

 

11_edi_08_02_mainmenu

 

 

Next you will see this image:

 

 

11_edi_08_03_mainmenu

 

Select 'Yes' because an ANSI X.12 file is difficult to read without reformatting. Next you will see a screen like this:

 

 

11_edi_08_04_report_edi